THE MISSING ZINC

Recently I wrote an article about the drug remdesivir and the fact that it is the current frontrunner in the race to find a treatment for COVID-19. Remdesivir replaced Chloroquine and hydroxychloroquine as the favored option due to evidence of complications related to the heart. In addition, several studies on the chloroquines are returning with lack of evidence regarding their effectiveness. Other studies are still in progress, but are they looking at the right combination of drugs?

The chloroquines entered the spotlight when a NYC physician named Vladimir Zelenko claimed that his patient population avoided, for the most part, the ravages of severe COVID-19 infection by taking the following outpatient treatment regimen:

• Hydroxychloroquine 200mg twice a day for 5 days
• Azithromycin 500 mg once a day for 5 days
• Zinc Sulfate 220 mg a day for 5 days

Hydroxychloroquine is an inexpensive well-known drug used for decades in the treatment and prevention of malaria. Azithromycin is a popular antibiotic previously described by myself in the past; zinc sulfate is a supplement of an important mineral.

President Trump has focused attention on hydroxychloroquine by speaking favorably about it, which has unleashed a storm of criticism by his detractors. The polarization around the drug therapy has spawned a number of studies about whether hydroxychloroquine is effective against COVID-19 or not. The majority of media reports suggest it is not.

These studies, as far as I can tell, evaluate the effect of chloroquine alone or in combination with azithromycin, but without any mention of zinc. Yet, Dr. Zelenko not only used zinc sulfate but feels it is this mineral that slows viral replication; the chloroquines act mostly as an aid to zinc. The azithromycin is added only to prevent secondary bacterial infections, not to combat the SARS-CoV2 virus itself.

Zinc, not chloroquine, may be a key part of the combination therapy. Yet, it appears to be left out of the studies.

The National Institute of Health, for example, is planning a study of 2000 patients described: “Participants will be randomly assigned to receive short-term treatment with either hydroxychloroquine and azithromycin or matching placebos.” If something additional, like zinc sulfate at 220mg, is added to the study, it should be mentioned. It isn’t.

Therefore, it doesn’t surprise me that a chloroquine would have questionable benefit without zinc supplementation. It also doesn’t surprise me that, at some of the higher doses used by some studies, adverse reactions to chloroquines would be reported. After many decades, we’ve figured out what an optimal dose is, albeit for malaria. Testing it at much higher amounts should increase the amount and severity of side-effects.

ABOUT ZINC

Zinc is an often-forgotten aid to health. It is found in every cell of the body and is integral to immune function and many other body processes. Failure to maintain adequate amounts of this essential trace element is not uncommon in those over sixty, the population that seems to suffer most with COVID-19 infection.

Zinc allows the body to produce and activate immune cells that respond to infection. Zinc may also modulate the body’s immune response in order to prevent the severe inflammation that can destroy lung tissue. This is what’s killing severe cases of COVID-19 patients.

The body doesn’t store excess zinc, so it must be obtained in foods such as beef, shellfish, nuts, cheese, chicken, and oats. Zinc toxicity may occur if excessive amounts are taken over time, but Dr. Zelenko’s regimen calls for only five days of treatment.

It’s true that Dr. Zelenko didn’t perform a peer-reviewed, random double-blind controlled study. Personal observations on his own patients and some protocols used in Asia and France are the extent of his evidence.

I’m not surprised at the criticism leveled by academics (and media) on his data. It’s important, however, to duplicate his methods as closely as possible if you’re going to fairly evaluate success or failure.

Just testing chloroquine and/or azithromycin without the addition of zinc is insufficient, in my opinion, to say that his treatment protocol is worthless. Until a study includes zinc, university scientists and the media shouldn’t assume so.

The missing zinc may be the missing link.

Note: Just because I haven’t found a study using chloroquines and zinc as part of the protocol doesn’t mean it doesn’t exist. If you know of one that does, please let me know.

Joe Alton MD